Palomar to close Escondido nursing home

Citing Medi-Cal funding cuts, and coming off a difficult fiscal year, Palomar Health will close its Escondido nursing home in October, a decision that will displace more than 80 residents and cause 130 layoffs, a health system official said Friday.

Steve Gold, chief officer for post acute care at Palomar, said the Palomar Continuing Care Center, a 96-bed facility on Avenida Del Diablo in Escondido, stopped taking new patients on July 1.

The issue, Gold said, is the state’s elimination of special reimbursements for nursing homes run by hospital systems. On top of that, Palomar will likely have to return $3 million to $4 million in previously received cash that is subject to a “clawback” provision in the state’s budget.

Palomar has also faced budget difficulty this year as it pays for a new $956 million 11-story hospital in west Escondido and also faces cuts to Medicare reimbursements.

Money troubles will not, however, force Palomar out of the skilled nursing market completely. Villa Pomerado, a 129-bed facility attached to Poway’s Pomerado Hospital, will remain open despite a similar funding gap, Gold said.

That facility, the administrator added, is newer than its sister in Escondido and does a larger short-term rehabilitation business, which is critical to getting patients out of even-more-expensive hospital beds.

Sharp HealthCare is the only other health system in San Diego County that operates its own nursing home.

In April, Sharp joined with Palomar to support a bill that would have restored funding for the facilities. Gold said Gov. Jerry Brown has indicated he will veto the bill, AB900, if it passes.

On Friday afternoon, Sharp issued a short statement that said the system has not yet made a decision on whether to keep its 95 skilled nursing beds.

“We await the determination of our governor and legislator on items such as AB900; and we hope that a reversal of current and looming cuts can prevent further closures in California,” the statement said.

Palomar’s decision to close the Escondido facility means transferring out its patients, and Gold said that process has started.

“Some families are choosing to leave now because they are afraid there will be no availability in October. When we made the announcement our census was 82 and, by Monday, we were down to 71,” Gold said.

He said that about 30 of the facility’s patients will be very difficult to place in other local nursing homes because they require feeding tubes or expensive medications or have suffered a traumatic injury, like a gunshot wound to the head, that causes disruptive behavior like constant screaming.

Gold said Palomar is working to find places for each patient but may need help from the state if no private facility is willing to take the most difficult cases. He said that some might not be able to find a facility in San Diego County.

“We could have some who have to go as far a 300 and 400 miles away,” Gold said.

An official with the California Department of Public Health said in an email Friday afternoon that it is monitoring the process but added that finding a new home for nursing home residents is Palomar’s responsibility.

Gold said the issue is made even more difficult because some residents have lived at the Escondido facility for a long time.